MIAMI-CASS REMC

OPERATION ROUND UP®

3086 W. 100 N.

PO Box 168

Peru, Indiana 46970

(765) 473-6668· (765) 473-8770 Fax

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The role of the Advisory Board of the Miami-Cass REMC Operation Round Up Fund is to make the best use of the funds entrusted to us to support activities within the Miami-Cass REMC service territory and nearby communities, and to be sure that whatever gifts we make are handled wisely.

Because we want to be helpful to as many organizations as possible, we encourage you to seek funding from more than just the Miami-Cass REMC Operation Round Up Fund. We will not penalize you for doing that; in fact, when we see that you have been resourceful – that is, your organization is willing to put some of its own money into a program/project, and has received or is working on receiving support from other organizations as well – that lends strength to your proposal. Applications should be submitted before programs/projects have begun.

If your organization has funds to complete this program/project without our assistance, we assume you will fund it yourselves. Because it helps us to understand the priorities and financial health of an organization, we ask you to provide the requested financial information.

Once we have received a request, that request will go to the Advisory Board. The Board is free to support, question or deny any request. Once the board has approved a request, the application will go to the Miami County Community Foundation for further evaluation. Upon their review and approval, checks will be issued to the grant recipients. If your organization is not selected, you may re-apply no sooner than 1 year to be reconsidered for the same program/project.

Grant proposals will be reviewed using the following guidelines:

  • Is there an established need for the program/project?
  • To what extent is the program/project problem solving in nature?
  • Is it appropriate to make a grant for the requested purpose, or are there more compatible sources of potential funding?
  • Are there adequate resources to effectively respond to this request?
  • To what degree is the potential benefit to the community and/or nearby communities?
  • What is the capability of the organization and its personnel to achieve expected results?
  • Is the timing appropriate to carry out the program/project?
  • What evidence is there of cooperation and coordination with other organizations at this time?
  • Is there a possibility the grant will stimulate matching funds from other sources?
  • Does the grant application fit the overall charitable purposes of Operation Round Up?

GRANTPERIODS

First Quarter Second Quarter Third Quarter Fourth Quarter

Deadline for applications March 31st June 30th September 30th December 31st

Board action 3rd Wed in April 3rd Wed in July 3rd Wed in Oct 3rd Wed in Jan

AREAS OF CONSIDERATION

Cultural

Education

Recreation

Human Services

Health and Medical

Community Development

Environmental Awareness

APPLICATION PROCEDURES

1. The following information MUST accompany the application:

  • A one-page budget for the amount requested, with justifications______
  • Proof confirming 501(c)(3) status with the IRS (if applicable) ______
  • A copy of the most recent audited financial statements or annual report______
  • Current organizational budget (if not available please explain) ______

2. Mail or deliver the application, copies and supporting materials to:

Miami-Cass REMC

Operation Round Up

3086 W. 100 N. • PO Box 168

Peru, IN 46970

3. Submit a total of one complete set of the application and documentation. (original only needed)

4. A contact person must be indicated should there be questions regarding the request.

5. Applications received after a deadline will automatically be considered the following quarter unless revoked by applicant.

Questions regarding the application or process can be directed to Kim Burton, Director of Member Services, Miami-Cass REMC:

Local: 765-473-6668

Email:

MIAMI-CASS REMC OPERATION ROUND UP

3086 W. 100 N.

PO Box 168

Peru, Indiana 46970

(765) 473-6668· (765) 473-8770 Fax

ORGANIZATION/AGENCY GRANT APPLICATION

TYPE OR PRINT ALL INFORMATION

Name of organization: ______

Date established: ______

Street address: ______PO Box: ______

City, State, Zip: ______

Daytime telephone: ______

Contact person: ______

Officers, Directors of the organization: ______

______

______

______

General objectives of the organization: ______

______

______

______

Describe the project/program for which funding is requested, attach additional page if necessary:

______

______

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Who and how many will benefit from this program/project? ______

______

______

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What are the specific results/outcomes that are expected? ______

______

______

______

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Amount being requested: $______

Date funds are needed: ______

Total program/project budget: $______

Other funding sources sought for this program/project: Amount:

______

______

______

Sources of firm pledges and commitments to date: Amount:

______

______

______

Is this a new organization?___ Yes ___ No

Is this organization a United Way Agency? ___ Yes ___ No

Is this a new program/project within an established organization?___ Yes ___ No

Is this grant to supplement an established program/project?___ Yes ___ No

Does this organization have tax-exempt status under section 501(c)(3) of the IRS Code? ___ Yes ___ No

If yes, attach proof confirming such status.

Have you received previous grants from the Miami-Cass REMC Operation Round Up Fund?___ Yes ___ No

If yes, when? ______Amount? ______What program/project? ______

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If this will be a continuing program/project, explain in detail the source of funds for operation in subsequent years:

______

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How do you plan to evaluate the success of your program/project?

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List 2 references: (May not be a Miami-Cass REMC Director or employee or an Advisory Board member of the Miami-Cass REMC Operation Round Up Fund.)

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NAMEPHONE

______

ADDRESSCITYSTATEZIP CODE

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NAMEPHONE

______

ADDRESSCITYSTATEZIP CODE

List ways we might be recognized for awarding this grant (i.e. our logo on signage, t-shirts; media photo opportunities, etc):

______

______

Any other pertinent information that would aid in the evaluation of your grant request:

______

______

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If the Miami-Cass REMC Operation Round Up Advisory Board is unable to approve your request for funds, what alternatives do you have?

______

______

If we support your program/project a Final Report (Program & Financial) detailing the use of the grant money and a photograph of the program/project is required to be filed with us at completion of the program/project. Such report & photo will be sent ______.

(approximate date if not specifically known)

The information contained in this statement is for the purpose of obtaining funding from the Miami-Cass REMC Operation Round Up Fund on behalf of the undersigned. Each undersigned understands that the information provided herein is used in deciding to grant funding, and each undersigned represents and warrants that the information provided is true and complete and that the Miami-Cass REMC Operation Round Up Advisory Board is authorized to make all inquiries deemed necessary to verify the accuracy of the statements made herein. Each undersigned understands in applying for funding, that if granted, it will be used for the sole purpose as stated in this application and also grants permission for its publication in the Miami-Cass REMC monthly newsletter as well as any other publication Miami-Cass REMC deems appropriate.

For this application to be given consideration by the Miami-Cass REMC Operation Round Up Advisory Board it must be signed by the organization's President/Chairperson and by an individual to whom future questions and correspondence may be addressed (must be two different persons):

______

President/ChairpersonContact Person

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Printed NamePrinted Name

______

Date SignedDate Signed

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